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NPI Code Detail

MEDICARE: SOUTH CENTRAL FAMILY HEALTH CENTER

MEDICARE: SOUTH CENTRAL FAMILY HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)960000260CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BCP70315FOTHERCACANCER DETECTION PROGRAM
2EAP70315FOTHERCAEAPC
3HAP70315FOTHERCAFAMILY PLANNING
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396891909
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH CENTRAL FAMILY HEALTH CENTER
Provider Business Mailing Address
First Line : 4425 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-3629
Country : US
Telephone Number : 323-908-4239
Fax Number : 323-908-4256
Provider Business Practice Location Address
First Line : 4425 S CENTRAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-3629
Country : US
Telephone Number : 323-908-4239
Fax Number : 323-908-4256
Authorized Official
Title or Position : C.F.O.
Name : PAUL RAMOS
Credential :
Telephone Number : 323-908-4239
Provider Enumeration Date : 01/26/2007
Last Update Date : 03/30/2016

Similar Medicare Providers

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Practice Location Address:
4425 S CENTRAL AVE
LOS ANGELES, CA
90011-3629
Practice Phone: 323-908-4274
Practice Fax: 323-908-4262
1689735979 — ELIZABETH DEVINE MSN FNP
Practice Location Address:
4425 S CENTRAL AVE
LOS ANGELES, CA
90011-3629
Practice Phone: 323-908-4200
Practice Fax:
1003965542 — RUBEN GARCIA DE ALBA PA-C
Practice Location Address:
4425 S CENTRAL AVE
LOS ANGELES, CA
90011-3629
Practice Phone: 323-908-4200
Practice Fax: 323-908-4262
1336290691 — MR. JOSE L PEREZ M.D.
Practice Location Address:
4425 S CENTRAL AVE
LOS ANGELES, CA
90011-3629
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Practice Fax:
1962553651 — DR. JOHN DENNIS MULL MD MPH
Practice Location Address:
4425 SOUTH CENTRAL AVE , SOUTH CENTRAL FAMILY HEALTH CENTER
LOS ANGELES, CA
90011-3629
Practice Phone: 323-908-4219
Practice Fax: 323-908-4262
1235276429 — HORTENCIA ARANDA
Practice Location Address:
4425 S CENTRAL AVE
LOS ANGELES, CA
90011-3629
Practice Phone: 323-908-4200
Practice Fax: 323-908-4262

Directions to “SOUTH CENTRAL FAMILY HEALTH CENTER ” Practice Location

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